Could Ozempic be used as an anti-addiction drug?

By now, you’ve probably heard about the wonders of Ozempic as an effective and safe weight loss drug. Celebrity endorsements abound, but this isn’t just a drug for the elite. According to one informal survey published in March of 2023, 15% of Americans have used Ozempic for weight loss, and 22% have asked their doctor to prescribe them Ozempic for weight loss. 

More recently, there’s been talk in the media about Ozempic causing a bonus effect: helping people taking it curb a variety of addictions with no apparent connection to weight. 

Do these claims hold any water? Could Ozempic help treat addictive behaviors? Here’s what we know. 

Ozempic (active ingredient: semaglutide) is an injectable drug that’s currently only approved by the US Food and Drug Administration (FDA) for helping people with type 2 diabetes mellitus control their blood sugar. It’s highly effective at making weight loss easier, though, so many healthcare providers prescribe it off-label for that purpose. 

So, how does this drug work so well for weight loss? 

It’s a type of drug called a glucagon-like peptide-1 receptor agonist (or GLP-1 for short). There are several drugs in this class, including another brand name of semaglutide—Wegovy—which is FDA-approved for weight loss. 

GLP-1 is a natural hormone involved in appetite regulation (among many other actions). Taking a GLP-1 drug like Ozempic causes the GLP-1 receptors throughout the body to activate, which decreases appetite. It also slows down digestion, making you feel full for longer. 

While we know Ozempic can help with weight loss, there isn’t much research (yet) on its effects on addictive behaviors and the reports we’re hearing are anecdotal.  More research needs to be done, particularly human clinical trials, to find out if Ozempic and other semaglutide medicines really have this effect.  

We spoke with Dr. Raoul Manalac, an obesity specialist and Ro’s Senior Director of Clinical Experience.  He says the GLP-1 receptors in the brain “may be in areas that interact with the areas of the brain involved in addiction.” Therefore, GLP-1 drugs could influence interest in things like cigarettes or other addictive substances. 

“The presence of GLP-1 in these areas of the brain,” says Dr. Manalac, “could decrease the influence of these systems in seeking behaviors that reinforce addictions, such as alcohol, cigarette, cocaine, or opiate use.” 

As of now, research is very limited on how GLP-1s like Ozempic may affect addictive behaviors in humans, but we have some information. In rodent and primate studies, GLP-1s have been shown to decrease the intake of alcohol and addictive drugs. 

We know that being addicted to one substance or behavior might make you more likely to also experience other addictions. So, it’s very possible that Ozempic (and other GLP-1s) could affect a wider range of addictive behaviors than what’s currently being studied. 

Dr. Manalac adds, “There are ongoing trials for alcohol abuse and smoking cessation. There is also interest and investigation in areas such as cocaine and opioid use disorder.”

For now, though, the main clinical trials underway are on how GLP-1s can impact alcohol use disorder, nicotine usage, and opioid use disorder. 

It’s possible that semaglutide, the active ingredient in Ozempic, could become available as an anti-addiction drug in the future, but we’re not even close to that point now. The few trials in the works are small (with under 50 participants in each), and the findings aren’t yet conclusive. For this drug to be approved to treat certain addictions, we would need large-scale trials to show it’s safe and effective for that purpose. 

Still, with further study on this effect, the FDA may eventually approve it for this use, either under an existing drug name or under a new brand name. This wouldn’t be the first time that a drug gets approval for something it wasn’t designed for. Remember Viagra (sildenafil), which was originally developed to treat high blood pressure? The rest is history. 

When exploring Ozempic’s potential anti-addiction effect, one interesting phenomenon is the complete opposite effect weight loss surgery can have on addiction.

Weight loss surgery is a life-saving procedure for many, but researchers have found that there might be a risk of developing an alcohol use disorder or substance use disorder after bariatric surgery. We don’t know for sure why this happens, but there are a couple of theories, as Dr. Manalac shares. “One theory is this could represent ‘addiction transfer,’ with a transition of behaviors such as binge eating transferred to an addictive substance, since patients can no longer eat in this manner.”

That wouldn’t exactly explain why GLP-1s would have the opposite effect. After all, one of the primary ways GLP-1s work is by lessening how much food you want to eat. 

“Another theory,” says Dr. Manalac, “is the association with psychosocial stress. Before surgery, patients may have coped with these stressors with eating, but since this is no longer available, they transition to other mechanisms to cope.”

That still doesn’t explain the extreme difference in how weight loss surgeries and GLP-1s impact addictive behaviors. The most plausible explanation, according to Dr. Manalac, is the effect on GLP-1 itself. As we explained earlier, the GLP-1 receptors in the brain are likely interacting with parts of the brain related to addiction, so that could be the source of this effect. 

You won’t be able to get your hands on Ozempic to curb any addictive behaviors you may have, just yet, but you may be wondering how to get Ozempic for weight loss. Since Ozempic isn’t approved as a weight loss drug, you might think it’s difficult to get it for that purpose. Thankfully, that’s not the case. 

There had been shortages of Ozempic due to increased demand, but Novo Nordisk, Ozempic’s manufacturer, seems to be working on resolving these issues as of May 2023. Meanwhile, there is currently a Wegovy shortage that is expected to last at least through September 2023. Novo Nordisk, the makers of Wegovy, said that there is a shortage of the 0.25 mg, 0.5 mg, and 1 mg strengths of Wegovy. They don’t expect any supply interruptions for the 1.7 mg and 2.4 mg strengths. 

If you’re interested in Ozempic specifically for weight loss, you have several options: 

• Discuss it with your general practitioner or with an obesity medicine specialist to see if you’re a good candidate. 

• Contact your health insurance provider to find out if they’ll cover Ozempic. If not, see if they’ll cover Wegovy instead (you can also ask if they cover semaglutide). 

• Check out our Ro's Body Program, which includes your prescription medication (if you’re eligible), a smart scale, guidance from a health coach, one-on-one support from your healthcare provider, an insurance concierge to help you determine coverage, a detailed curriculum to help you stay on track, and more. 

Your provider may recommend another GLP-1 instead, depending on current shortages, your health profile and your insurance coverage. 

For now, the link between Ozempic and curtailing addictive behaviors is mostly anecdotal. You’ll get the most benefit from its effects on diabetes and weight management. Speak with your provider to find out more.

---

How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Current version

June 15, 2023

Written by

Rachel Honeyman

Fact checked by

Felix Gussone, MD

---

About the medical reviewer

Felix Gussone, MD, Ro

Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.